Disfiguring facial infection in young children can be prevented

Noma – a disfiguring infection that leads to rapid destruction of the face and mouth in young children - can be prevented by a number of known measures, state the authors of a Seminar in this week's issue of The Lancet.

Noma is found worldwide; sporadic cases have been recently reported in Europe and the US but the disease is most common in sub-Saharan Africa. Noma occurs primarily in malnourished, young children aged 1-4 years and often follows an illness such as measles, tuberculosis, or immunodeficiency. It is a disease promoted by extreme poverty and is common in environments with unsafe drinking water and poor sanitation. Noma becomes established very rapidly leaving patients little time to seek medical attention, so prevention is key.

In their Seminar Cyril Enwonwu (University of Maryland at Baltimore, MD, USA) and colleagues list six factors for the prevention of noma. They state that because parents and many health workers do not know about the disease, information campaigns are needed at a national, regional, and village level. At the governmental level, eradication of poverty should be a top priority, they add. Other prevention strategies include improvement of living conditions, segregation of livestock from human living quarters, promotion of good oral-hygiene practices, exclusive breastfeeding in the first few months of life, and timely immunisation against common childhood diseases.

Professor Enwonwu states: "Noma robs many children of their future. There is urgent need for countries where noma is still prevalent to set up control plans that emphasise prevention and early detection of the disease, while addressing poverty, environmental hygiene, perinatal health care, maternal and infant nutrition, and timely immunisation against endemic diseases, particularly measles."